Information Request Form

Student Disability Resources Introductory Questionnaire

Submission of this form prior to starting at PSU will result in further correspondence from the campus Disability Resources Coordinator to provide additional information concerning services. Early receipt of this form will allow for a more timely response to your request for services. Completion of this form is optional. All students should consult the PSU Office for Student Disability Resources website for additional information.

Students are required to self-identify by contacting the Disability Resources Coordinator. You may contact Jordan Rummel at jrr5565@psu.edu 814-372-3037.

This publication is available in alternative media on request.